Using the STOP-BANG Questionnaire to assess Sleep Apnoea & OSA
Do You Have Sleep Apnoea or OSA? Find Out with the STOP-BANG Questionnaire If you…
Nasal obstruction can significantly impact breathing, sleep, and overall quality of life. At Melbourne ENT, located in St Kilda East, Victoria, we recognise how distressing these symptoms can be and are committed to helping patients find effective, lasting solutions. Our highly experienced ENT Surgeons, Dr Stephen Kleid and Dr Simon Braham, use the NOSE scale to assess and guide accurate diagnosis and personalised treatment plans. The Nose Score is also used as a criteria for some Nose Surgery Medicare Item Numbers.
As part of our evidence-based approach to diagnosis and care, we use the NOSE Scale Score – an internationally respected tool for assessing nasal obstruction. By incorporating modern diagnostic tools like nasoendoscopy and MRI alongside clinical examination and nose imaging, Melbourne ENT provides a complete picture of each patient’s nasal health.
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Nasal obstruction refers to a partial or complete blockage of the nasal passages. It can be caused by a variety of issues including a deviated nasal septum, enlarged turbinates, nasal valve collapse, nasal polyps, or chronic sinusitis. Allergies, infections, and structural abnormalities are also common contributors. These conditions can result in symptoms such as difficulty breathing through the nose, frequent congestion, postnasal drip, facial pressure, snoring, and disrupted sleep. Many patients also report difficulty exercising, a diminished sense of smell, or frequent headaches associated with sinus pressure.
In children, nasal obstruction may lead to mouth breathing, sleep apnoea, and issues with facial development or concentration at school. Persistent obstruction during childhood can impact sleep quality and even behaviour, leading to fatigue and reduced academic performance. For both adults and children across Melbourne, accurate assessment is critical to effective treatment – and that’s where the NOSE Scale Score becomes invaluable.
The N.O.S.E. (Nasal Obstruction Symptom Evaluation) Scale is a simple, patient-reported outcome measure used to quantify nasal obstruction severity. Patients rate five key symptoms that reflect the real-world impact of nasal issues on daily functioning and comfort.
Each symptom is rated on a scale from 0 (not a problem) to 4 (severe problem), and the combined score is then multiplied by five, producing a final score ranging from 0 to 100. A higher score reflects more severe obstruction and highlights the need for further evaluation and possible intervention.
This tool is widely accepted in ENT practices worldwide and is integral to care at Melbourne ENT. Our surgeons commonly use it during initial assessments and follow-up visits to measure each patients progress and refine treatment plans. It ensures the patient’s experience is central to decision-making, and provides measurable feedback that supports clear, goal-oriented treatment strategies.
The NOSE Scale (Nasal Obstruction Symptom Evaluation) is a validated patient-reported outcome measure used to quantify the impact of nasal obstruction on quality of life. It is widely used in both clinical practice and research, especially in rhinoplasty and septoplasty evaluations.
Here’s how to calculate the NOSE score:
The patient answers five questions, rating the severity of each nasal obstruction symptom on a scale of 0 to 4:
Score | Description |
---|---|
0 | Not a problem |
1 | Very mild problem |
2 | Moderate problem |
3 | Fairly bad problem |
4 | Severe problem |
Questions:
Formula:
NOSE Score = (Sum of 5 item scores) × 5
Example:
Question | Patient Response |
---|---|
1 | 3 |
2 | 2 |
3 | 2 |
4 | 1 |
5 | 2 |
Total | 10 |
Final NOSE Score = 10 × 5 = 50
While there’s no strict clinical cutoff, general interpretations are:
This can be tracked before and after surgery (e.g. septoplasty, rhinoplasty, turbinate reduction) to evaluate improvement.
Access a PDF copy of the NOSE Scale Assessment Instrument
Medicare Item Numbers 45632, 45635, 45641, 45644 and 45650 can require a Nose Scale Score > 45.
The NOSE Scale enhances the consultation process by offering a standardised way to measure symptom severity. It allows clinicians and patients to compare pre- and post-treatment states, demonstrating the effectiveness of medical therapy or surgery. It also provides a structured framework for long-term monitoring in patients with chronic or recurring nasal obstruction, reinforcing our commitment to continuous care and optimal outcomes.
Melbourne ENT offers a comprehensive range of treatments for nasal obstruction, tailored to individual anatomy and severity of symptoms. The decision to proceed with surgery or medical treatment depends on the root cause of the obstruction, the NOSE score, and the patient’s overall health, preferences, and lifestyle.
Septoplasty corrects a deviated septum, one of the most common causes of chronic nasal obstruction. Turbinoplasty reduces swollen nasal turbinates that can block airflow. For patients requiring aesthetic or functional refinement of the nasal structure, Dr Kleid’s expertise in rhinoplasty and revision rhinoplasty offers advanced options that combine form and function. Nasal valve surgery is often essential in patients with collapsed or weak nasal sidewalls. Where surgery is not appropriate or necessary, our support team provides ongoing medical management including nasal sprays, antihistamines, decongestants, and allergy immunotherapy.
If you experience persistent nasal congestion, trouble breathing through your nose, snoring, or sleep disturbances, it may be time to seek expert evaluation. Left untreated, nasal obstruction can lead to chronic fatigue, poor sleep quality, and impaired cognitive function. For athletes and active individuals, poor nasal airflow can reduce physical performance. For those with sleep apnoea, unaddressed nasal obstruction can worsen symptoms and increase the risks of heart disease and hypertension.
At Melbourne ENT, we welcome patients from across Melbourne and surrounding suburbs, offering in-depth assessments and world-class treatment. Whether the obstruction is functional, structural, or related to allergies, we can help identify the cause and provide targeted solutions. Our clinic is committed to identifying the most effective intervention for each individual, from non-invasive treatments to complex reconstructive procedures.
Dr Stephen Kleid brings decades of ENT expertise, with extensive experience at prestigious hospitals including Royal Melbourne Hospital and Peter MacCallum Cancer Centre. Dr Simon Braham complements this with his refined skills in facial plastic surgery and ENT, consulting at the Royal Victorian Eye and Ear Hospital. Together, they deliver comprehensive ENT care informed by clinical best practices and the latest research.
Both Dr Kleid and Dr Braham are Fellows of the Royal Australasian College of Surgeons and are dedicated to delivering compassionate care to both adult and paediatric patients. Their collaborative approach ensures that each patient benefits from a full spectrum of ENT expertise.
Melbourne ENT is conveniently located in St Kilda East and serves the greater Melbourne area, including nearby hospitals and healthcare networks. We work closely with referring GPs, respiratory specialists, and paediatricians to coordinate patient care. Our team offers a seamless patient journey – from initial consultation and diagnostics to treatment and post-operative care.
Dr Stephen Kleid and Dr Simon Braham are proud to offer their collective expertise to ensure that each patient receives thoughtful, evidence-based care. Their multidisciplinary approach and collaborative ethos make Melbourne ENT a trusted name in nasal and sinus surgery.
Our clinic maintains a strong commitment to clinical education and innovation, continually refining our practices to reflect the most current standards of care.
If nasal obstruction is affecting your quality of life please book a consultation with Melbourne ENT. Our experienced team will utilize tools like the NOSE Scale Score to thoroughly assess your condition and recommend a treatment plan tailored to your individual needs. We understand that every case is unique, and our goal is to help you breathe better, sleep soundly, and feel more energised throughout your day.
For appointments or further inquiries, contact the team for Dr Simon Braham on (03) 9038 1311 or Dr Stephen Kleid on (03) 9038 1630.
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